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. 2021 Apr 13;8:649785. doi: 10.3389/fcvm.2021.649785

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Copyright © 2021 Wang, Liu, Liang, Naruse and Takahashi.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Development of atherosclerosis via ROS production in the polyol pathway in the condition of hyperglycemia. In the process of the reduction of glucose to sorbitol by aldose reductase, NADPH is oxidized to NADP⁺, consuming NADPH. As NADPH is essential for regeneration of antioxidant glutathione (GSH), the reaction of reducing H₂O₂ to H₂O is suppressed. The accumulation of H₂O₂ causes inflammation, resulting in the development of atherosclerosis. GSSG, glutathione disulfide.